| Memory Keepers, Llc | |
|
747 Samoa Dr Saint Louis MO 63126-1458 | |
| (314) 749-8783 | |
| Not Available |
| Full Name | Memory Keepers, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 747 Samoa Dr, Saint Louis, Missouri |
| Authorized Official Name and Position | Victoria Shepherd (ADMINISTRATOR) |
| Authorized Official Contact | 3143155148 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Memory Keepers, Llc 747 Samoa Dr Saint Louis MO 63126-1458 Ph: () - | Memory Keepers, Llc 747 Samoa Dr Saint Louis MO 63126-1458 Ph: (314) 749-8783 |
| NPI Number | 1114693611 |
|---|---|
| Provider Enumeration Date | 08/17/2021 |
| Last Update Date | 08/25/2021 |
| Certification Date | 08/25/2021 |
| Medicare PECOS PAC ID | 7315345790 |
|---|---|
| Medicare Enrollment ID | O20211015000831 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114693611 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Cheryl Kinney |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992328710 PECOS PAC ID: 7315362084 Enrollment ID: I20200729001942 |
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